Shaping for Cleaning: Reconsidering Root Canal Debridement

Deus, Gustavo De; Silva, Emmanuel João Nogueira Leal; Souza, Erick Miranda; Versiani, Marco Aurélio; Zehnder, Matthias; Zuolo, Mário Luis

doi:10.1007/978-3-030-84617-6_2

Cited by 4 publications

(6 citation statements)

References 147 publications

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“…The less‐than‐ideal results observed in various studies that utilized different methodologies for canal shaping places significant emphasis on canal irrigation, indicating that the final intracanal disinfection is largely dependent upon the physicochemical action of irrigation. Root canal irrigation, however, has its own limitations and is indeed dependent on multiple factors 137 . Laboratory experiments have highlighted that areas of dentinal wall surfaces untouched by instruments during mechanical preparation can retain attached biofilms, potentially concealed by hard‐tissue debris 138 .…”

Section: Shaping For Cleaning: Reconsidering Root Canal Disinfectionmentioning

confidence: 99%

“…Root canal irrigation, however, has its own limitations and is indeed dependent on multiple factors. 137 Laboratory experiments have highlighted that areas of dentinal wall surfaces untouched by instruments during mechanical preparation can retain attached biofilms, potentially concealed by hard-tissue debris. 138 Therefore, in complex canal systems like molars or oval-shaped canals, where instruments cannot adequately prepare canal walls, the NaOCl solution must reach these unprepared areas.…”

Section: Shaping For Cleaning: Reconsidering Root Canal Disinfectionmentioning

confidence: 99%

“…These methods involve novel systems and substances that either supplement or replace conventional chemomechanical procedures and encompass negative pressure irrigation, final rinses with supplementary irrigant solutions, ultrasonic activation, photodynamic therapy, photon-induced photoacoustic streaming, multisonic waves and specialized instruments designed to adapt to irregular root canal anatomy. 137 Hence, although these methods show the potential to enhance cleaning and disinfection within a single session, the majority of current findings are derived from in vitro studies, thereby reflecting a low level of evidence. Nowadays, there is no consistent clinical evidence demonstrating that these approaches can consistently achieve a substantial reduction in bacterial bioburden below the levels accomplished by traditional instrumentation and irrigation.…”

Section: Shaping For Cleaning: Reconsidering Root Canal Disinfectionmentioning

confidence: 99%

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Anatomical complexities affecting root canal preparation: a narrative review

Versiani,

Martins,

Ordinola‐Zapata

2023

Australian Dental Journal

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A fundamental aspect of the Endodontic field is the knowledge of root canal anatomy. Using a variety of techniques, the internal and external anatomy of teeth have been extensively investigated throughout the past century. Recent improvements in three‐dimensional computed tomography have enabled more detailed evaluations of root canal morphology in both clinical and laboratory settings. Essentially, researches have unveiled that the root canal constitutes a complex system, comprising not only the main root canal but also lateral components, including isthmuses, fins, accessory canals and apical ramifications. Undoubtedly, this intricate morphology poses a significant challenge when it comes to the process of shaping, cleaning and disinfecting the root canal system. This article aims to explore the anatomical aspects of the root canal system that impact the chemomechanical procedures.

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Section: Shaping For Cleaning: Reconsidering Root Canal Disinfectionmentioning

confidence: 99%

Section: Shaping For Cleaning: Reconsidering Root Canal Disinfectionmentioning

confidence: 99%

Section: Shaping For Cleaning: Reconsidering Root Canal Disinfectionmentioning

confidence: 99%

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Anatomical complexities affecting root canal preparation: a narrative review

Versiani,

Martins,

Ordinola‐Zapata

2023

Australian Dental Journal

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“…The apically extruded debris (AED) during root canal shaping and cleaning is a principal reason for the failure of the endodontic treatment procedure [1]. The chemomechanical disinfection of root canals is defined by shaping the root canals to be appropriately irrigated [2]. During instrumentation, infected pulp tissue remnants, dentinal chips, bacterial byproducts, and irrigation solutions can be pushed throughout the apical foramen to the periapical tissue [3].…”

Section: Introductionmentioning

confidence: 99%

A Comparative Evaluation of the Apically Extruded Debris from Root Canals Prepared by R-Motion NiTi File System

Al-Saffar

Al-Gharrawi

2023

International Journal of Dentistry

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Background. Apically extruded debris (AED) is an inherent concern during root canal treatment for both endodontists and general practitioners. The present study investigates the AED of the novel R-Motion single-file reciprocating system compared to standard single reciprocating and multifile rotary systems. Materials and Methods. Fifty-six moderately curved palatal roots of upper maxillary first molars were selected for the present study. The samples were then divided randomly into four groups (n = 14)— Group I: R-motion (RM), Group II: WaveOne Gold (WOG), Group III: ProTaper Next (PTN), and Group IV: HyFlex EDM (HFEDM). The researcher has modified Myers and Montgomery’s method to simulate human body temperature. Vials were used to collect debris and weighted using a 0.00001 sensitive balance before and after instrumentation. The instrumentation of all experimented groups was done at 37°C, terminated at master apical file #25. An auto syringe with a side vented needle was used to deliver 8 ml of deionized water for irrigation of each sample during preparation. Vials were stored in a dry sealed desiccator which contained CaSO4 crystals, for 24 hr before weighing. The weight of the collected debris was obtained by subtracting the preinstrumentation weight from the postinstrumentation weight for each vial. The Kruskal–Wallis and Mann–Whitney U tests were performed to analyse the statistical difference in the amount of debris between the tested groups at a 0.05 significance level. Results. The RM system produced less debris extrusion than all tested groups, with a significant difference between the former and the WOG and the PTN systems. However, WOG, PTN, and HFEDM showed no statistically significant difference in the amount of AED. Conclusion. All tested groups produced apical debris in different amounts. The RM produced substantially less AED than WOG and PTN. Meanwhile, WOG, PTN, and HFEDM caused a comparable amount of AED.

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“…In addition to kinematics, other factors such as heat treatment and specific geometric features contribute to the distinctive characteristics of reciprocating instruments. The combination of these attributes has resulted in reciprocating instruments gaining widespread recognition and acceptance among both clinical and scientific communities (De‐Deus et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

Characterization of four heat‐treated reciprocating instruments: Design, metallurgy, mechanical performance, and irrigation flow patterns

Martins,

Silva,

Marques

et al. 2023

Int Endodontic J

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AimTo compare the design, metallurgy, and mechanical properties of four heat‐treated reciprocating instruments coupled with the evaluation of the irrigation flow using an in silico model.MethodologyNew EdgeOne Fire Primary, Easy‐File Flex Regular 25, WaveOne Gold Primary and Reciproc Blue R25 instruments (n = 124) were initially evaluated regarding their design through stereomicroscopy, scanning electron microscopy and 3D surface scanning. In addition, energy‐dispersive X‐ray spectroscopy was utilized to determine their elemental composition, and differential scanning calorimetry tests to evaluate their phase transformation temperatures. Their mechanical performance was further assessed through torsional and bending tests. Using scans obtained from a real tooth and the instruments, a computational fluid dynamics assessment was conducted to determine the irrigation flow pattern, apical pressure, and wall shear stress in simulated canal preparation. Mood's median and One‐way anova post hoc Tukey tests were used for statistical comparisons (α = 5%).ResultsReciproc Blue exhibited a superior number of blades (n = 8), whereas EdgeOne Fire had the highest overall volume (4.38 mm3) and surface area (32.32 mm2). At the 3‐mm axial level, EdgeOne Fire displayed the lowest core diameter (0.13 mm), while Reciproc Blue had the highest (0.16 mm). All blades were symmetrical, and the tips of the instruments were non‐active but differed from each other. The most irregular surfaces were observed in EdgeOne Fire and Easy‐File Flex. All instruments were manufactured from nickel–titanium alloys and exhibited distinct phase transformation temperatures. WaveOne Gold and Reciproc Blue demonstrated the highest maximum torque values (1.87 and 1.62 N cm, respectively), while the lowest was observed on EdgeOne Fire (1.21 N cm) (p < .05). The most flexible (p < .05) were EdgeOne Fire (angle of rotation: 602.6°; maximum bending load: 251.4 g.f) and Reciproc Blue (533.2° and 235.6 g.f). There were no significant differences observed in the irrigation flow among the four domains generated by the tested instruments.ConclusionsDespite observing variations in the design, phase transformation temperatures, and in the torsional and bending test outcomes among the four heat‐treated reciprocating instruments, no significant differences were found in the irrigation flow pattern among the different groups in the simulated root canal preparations.

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Shaping for Cleaning: Reconsidering Root Canal Debridement

Cited by 4 publications

References 147 publications

Anatomical complexities affecting root canal preparation: a narrative review

Anatomical complexities affecting root canal preparation: a narrative review

A Comparative Evaluation of the Apically Extruded Debris from Root Canals Prepared by R-Motion NiTi File System

Characterization of four heat‐treated reciprocating instruments: Design, metallurgy, mechanical performance, and irrigation flow patterns

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